Why are doctors conservative?

I caught up with an old friend for the first time in ages last week.  It would have been almost ten years and wow, how things have changed.  Ten years ago if we arranged to catch up we probably would have met at a cafe, restaurant or pub.  Now we met at a playground so the kids could run around and we could have at least five minutes uninterrupted adult conversation before the inevitable scraped knee or "dad, can you push me on the swing?"

But it was really great to catch up.  It had actually been so long that this guy had not only started a family since the last time I saw him, but he had put himself through medical school and was now of all things, a consultant neurologist.  Inevitably, the conversation started to a medical field as we both shared a common interest, albeit from different angles.  Him as a doctor, me as a patient.

Their was one really refreshing side to the conversation though.  I genuinely felt as though I was discussing the topic as an equal, even when it came to discussing my personal situation.  I don't know whether it was because we are friends, he has a respect for me intellectually as we both went to university together or that this is simply the style of medicine he wished to practice.  I'd like to think that it is a product of all three.  But the point is I felt like an equal.

As the conversation progressed the topic evolved to why doctors seemed to be more conservative in their treatment approach to what a patient would be?  Apparently there are studies that show that patients are greater risk takers than doctors.  I have done a search online for such articles, but have not found much. (admittedly, I did not look especially hard)

From this I derive two questions.  Firstly, why are doctors more conservative?  And second, who's right, doctor or patient?  So why are doctors more conservative than their patients?  As I've said before, when you have a chronic illness, it is with you 24/7.  It does not take a holiday, it doesn't even take tea break.  For the most part doctors only get a 15 minute snapshot of the disease in a clinical setting.  It is not nearly enough to even gain a vague understanding of what is experienced by the patient.  Coupled with the fact that medical students are taught an academic perspective to disease and not an empathic perspective means they really have no idea.

But they do have a great deal of contact with patients when they are undergoing a treatment.  When I was in hospital for my brain surgery, I was visited by a number of doctors every day.  During the six hour surgery there were four doctors present for the whole procedure.  So they get a very good understanding of the trauma a patient goes through for each different type of procedure.

But unless you can weigh up the trauma of a procedure against the trauma of living with a disease, you are not qualified to answer that question.  So who's right?  Well both are right.  So all the knowledge should be put on the table.  All available options should be discussed, and then I believe the patient should make the decision.  Doctors should also take into account the individual patients understanding of the disease and treatment options.  If it seems like the patient is taking an intelligent risk the doctor should support that.  It is the patients life.  They should be the ones that make the ultimate decision.

I would also like to add that it is the patient who takes the ultimate risk.  I understand that there is a burden to a doctor if something goes wrong.  But every treatment, no matter how small has risk.  If a doctor is not prepared to adversely affect a patient, no matter how hard they try to help, they should not be a doctor.  Unfortunately, unforeseen tragedy is always going to be a part of medicine.  But that should not stop us trying, because the surest way to lose is to not try at all.  Until next time, stay well:)